Short-Term Effect of Ambient Meteorological Factors on Hand-Foot-Mouth Disease: An Individual-Level Case-Crossover Study in Jiangsu, China
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Background
Hand, foot, and mouth disease (HFMD) represent a significant public health concern in the Asia-Pacific region, imposing a substantial burden that warrants urgent attention. However, the associations between individual-level exposure to ambient meteorological factors and the HFMD risk remain poorly understood.
Methods
Using a time-stratified case-crossover design, we examine the individual-level association between six meteorological factors (temperature, humidity, wind speed, radiation, surface pressure, and precipitation) and HFMD risk. Conditional logistic regression is employed to investigate the relationship between short-term exposure to meteorological factors and HFMD risk, considering lagged effects and adjusting for public holidays and time-varying grid-level HFMD susceptibility. Exposure-response curves are developed using natural cubic splines to model the non-linear associations, and then extreme meteorological exposure under different thresholds is considered.
Results
A total of 1,247,970 eligible cases are identified in the study. Each 1-unit increase in exposure to temperature, humidity, wind speed, and precipitation over a 10-day moving average (lag010) is associated with an elevated risk of HFMD, with odds ratios (ORs) of 1.0124 (95% CI: 1.0013, 1.0134), 1.0063 (95% CI: 1.0059, 1.0068), 1.0069 (95% CI: 1.0022, 1.0115), and 1.0081 (95% CI: 1.0069, 1.0092), respectively. In contrast, radiation and surface pressure exhibited a negative association with HFMD, with ORs of 0.9860 (95% CI: 0.9848, 0.9871) and 0.8780 (95% CI: 0.8660, 0.8900) at lag010. As the exposure thresholds for temperature, humidity, wind speed, and precipitation increase, the negative association between the excess magnitude and HFMD risk is strengthened, whereas the associations for radiation and surface pressure are reversed.
Conclusion
Our findings indicate that short-term exposure to most meteorological factors, except radiation and surface pressure, is associated with an elevated risk of HFMD, providing valuable insights for developing targeted preventive strategies and public health policies.
